A functional rural health centre shows the way in Bihar

A functional rural health centre shows the way in Bihar

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Read how a community transformed a defunct health centre into one of the best in the region in #Bihar. http://bit.ly/1IqhfNF

@OxfamIndia and partner helps a community transform its health centre in #Bihar. http://bit.ly/1IqhfNF

The Health Sub Centre (HSC) at Marwatoli village, which falls under Mahingaon gram panchayat in Kishanganj district of Bihar, is spacious, neat and well-equipped with a separate labour room.

Stationed on duty are two Auxillary Nurse Midwives (ANMs), who take turns to carry out immunisation as well as monitor and counsel pregnant women and adolescents. Normal deliveries are also carried out with great success at this model government-run facility.

It is hard to believe that only a year back the Marwatoli HSC was one of the numerous health sub centres that dot the region. Its structure was completely dilapidated and the compound was being used by the locals to dry clothes and graze cattle.

“For most people living in rural areas, a smoothly functioning health centre is nothing less than a dream come true. But this has been possible only due to our community’s persistence and determination to make the once-defunct HSC fully operational,” says Mahendra Prasad Harijan, 50, proudly. He is a ward member as well as a part of the local Village Health Sanitation and Nutrition Committee (VHSNC).

Under the National Rural Health Mission, VHSNCs are mandated to implement health initiatives in individual villages, although in Bihar these committees are working at the panchayat level.

In Marwatoli, however, a 15-member VHSNC has been formed to deal with local health issues, with the assistance of the Bihar Voluntary Health Association (BVHA), an NGO partnering Oxfam India in the DFID-supported Global Poverty Action Fund’s (GPAF) project, ‘Improving Maternal Health Status in Six States in India’.

The HSC in Marwatoli was set up in 2003 but for various reasons remained redundant for nearly a decade. “The only activity that used to happen was the monthly ‘tika divas’ or immunisation day – and that too intermittently. Everyone had to go to the crowded Kishanganj Sadar Hospital, 10 kilometres away, whether it was for treatment or for delivery. Locals were using the HSC compound to dry clothes and graze cattle,” recalls Anjari Begum, 26.

When the BVHA started advocacy in Marwatoli, one of the 10 villages in Mahingaon gram panchayat covered under the intervention, the first step was to identify active and concerned people who could become members of the VHSNC.

Oxfam India and its partner in the region guided the community to get health centre functional again.

Once that was done, field animators from the NGO conducted a series of personal interactions, talking to each of them about health issues and rights. Later, VHSNC members from all the 10 villages held meetings in each hamlet to discuss the common problems being faced in the area.

In Marwatoli, the main issue that came forth from this process that took place in 2013 was that of the defunct HSC and the difficulty the 1,842-strong population was facing while accessing medical care at the Kishanganj Sadar Hospital or the Primary Health Centre (PHC) at Belwa, 35 kilometres away.

“We decided that our priority was to get the HSC functional. For this, we started interacting with the ANM regularly and mounted a strong advocacy campaign,” shares Shimoli Devi, 30, adding, “we wrote letters to the panchayat and the District Magistrate and urged the ANM and the panchayat to use the untied funds given by the government to each village to repaint and refurnish the HSC, which was in a dilapidated state.”

According to Jawahar Yadav, 45, Mahingaon Panchayat Pradhan, the message from the people was so strong that the panchayat decided to put its weight behind them. This had the desired effect as finally the PHC, too, ordered Marwatoli’s ANM to open the HSC daily.

“The VHSNC has supported the service provider in maintaining cleanliness at the HSC and its surroundings while the untied funds have been employed to get the required equipment and handle the logistics. I see this as a major success story for the health initiative started in this panchayat by the BVHA,” he states.

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